Heparin Influence on Anticoagulation and Perioperative Hemostasis during Arterial Vascular Surgery

Worldwide, the anticoagulant heparin is administered to prevent thromboembolic
complications in patients undergoing arterial vascular surgery. There is
however no consensus with regard to perioperative heparin dosing requirements
in these patients, although the side effects of heparin can be severe.
Preliminary results from a heparin management study in patients undergoing
cardiac surgery with cardiopulmonary bypass show individual differences in the
response to heparin dosing among patients. In contrast to cardiothoracic
surgery, there is however no standard monitoring of the effect of heparin
during vascular surgery.
In this observational study we therefore would like to investigate the heparin
requirements of patients undergoing arterial vascular surgery using the
Hemostasis Management System (HMS; HMS Plus). The effects of heparin on
coagulation in these patients will further be evaluated using rotational
thromboelastometry. In this way a scientific foundation can be established to
develop protocolized heparin management in arterial vascular surgery.

To measure individual heparin requirements in 30 patients undergoing arterial
vascular surgery.

Observational patient cohort study.

Patients will be subjected to intraoperative blood sampling (5 times 8 ml).
Blood sampling will be performed while patients are under anesthesia using an
existing intravenous catheter, and this is therefore not associated with an
additional burden for the patient.